Meet the Instructors

Antoine Flahault

Professor of Public Health and Director of the Institute of Global Health (Faculty of Medicine, University of Geneva) and co-Director of Centre Virchow-Villermé (Université Paris Descartes)University of Geneva and Université Paris Descartes – Sorbonne Paris Cité

Rafael Ruiz De Castañeda

Institute of Global Health - Faculty of MedicineUniversity of Geneva

Defeating Ebola Together Week 4: The Response from Africa and the World
"Humanitarian Aid"

The doctors of these countries, as well

as the authorities and political leaders,

must be first in line to act and to educate, educate, educate.

This means that collaboration with and among Guinean,

Sierra Leonean and Liberian doctors is absolutely necessary.

And when I say doctors, I should say the entire medical profession: nurses,

caregivers, and volunteers

-- volunteers are a much-needed resource.

Now, there are challenges, of course.

I mentioned traditional healers whose positions are being challenged

and whose ill-advised approaches must be addressed.

Many of them claim to be able to cure Ebola, but

in fact they cannot and often end up contaminating themselves.

Already, 150 to 200 healthcare workers have died in these countries,

particularly in the most remote areas,

in villages that are inaccessible to health officials.

These three countries, then, should speak with one voice.

When a country suffers a military invasion, or some kind of coercion or

stigmatization, its residents flee to a neighboring country,

and this just creates more problems.

As far as the international community is concerned,

it would be foolish for us to believe, having

decided this is an African disease, that we are immune.

The disease can potentially spread throughout the world. That's how we have to look at it.

We, the Western medical community -- but also UN agencies and

NGOs -- must absolutely realize

that it can strike us too, that it can strike all of us.

Therefore, it is up to the UN and its medical branch,

the World Health Organization, or WHO, to issue guidelines.

Who will apply these guidelines?

First of all, volunteer doctors and NGOs

-- some very courageous non-governmental organizations are already

active in these three countries, and I must commend one of them in particular:

Doctors Without Borders.

It takes a lot of courage to keep working in

very difficult conditions, wearing cumbersome protective suits that

become unbearable after 40 or 50 minutes in these hot climates.

I repeat:

one half of all patients recover -- and we can improve this figure.

The world's conscience is content to give money, often with some delay. Granted, money is necessary.

It's been estimated that one billion dollars, at least, will be needed to defeat the disease.

But we can come up with a billion dollars. People come up with much, much greater amounts to fund wars.

We are waging a war against this virus.

In fact, the President of Guinea, Alpha Condé,

has called upon the people of Guinea, on an individual basis, to each declare war on Ebola.

How can we help the countries struck by the epidemic?

By being as close to the patients as possible: as I've mentioned,

early diagnosis is absolutely key in terms of recovery.

The sooner symptoms are identified and treated,

the greater the chances of recovery.

Many countries have made contributions.

Cuba provided a hospital with

I believe, about 100 doctors.

The U.S. have sent 3,000 soldiers to Liberia and we,

the French, have established a hospital in Guinea.

Americans in Liberia, Cubans in Sierra Leone, and

England will soon take part as well.

France set up a hospital in Guinea with 50 to 100 beds.

This is a military hospital, which is a good thing because the military knows the meaning of discipline,

and this crisis requires a very particular form of discipline,

one that Doctors Without Borders -- as of now, the only ones doing real work on the ground --

are sure to specify.

For instance, you need to set up tents isolated from each other based on different stages of the disease.

The hospital must be as close to possible to the infected areas.

Once there is a military presence -- I'm sure the French military will be there soon --

the timeframe for transporting blood samples to Conakry

to find out whether a person has the virus or not

will be considerably reduced.

Otherwise, the border is almost 1,000 kilometers away.

So diagnosis will be must faster.

The virus, however, only appears in the blood after

a certain period, which varies among carriers.

It can last anywhere from 4 to 20 days,

after which the patient is no longer contagious.

There are ways to train the local population

and volunteers -- and this is already starting in the hospitals of Guinea.

You take volunteers and

you give them a mission on the ground lasting

one to two months, working in shifts, so as to involve as many

doctors and healthcare workers from Guinea itself as possible.

At some point, activities will have to be

transferred to Africans themselves as much as possible.

Africans have already declared, after a meeting of the Heads of State, that they are going

to reopen the borders, the capitals, so that flights can land in Conakry, Monrovia, etc.

Because of the need for supplies, of course,

but also because this will allow various industries to start up again

and the countries to reestablish growth and normal economic activity.

There have been too many delays.

In France, the Ministry of Foreign Affairs and the Ministry of Defense

have crisis units in place on a permanent basis.

Some people think that crisis units are created in response to specific situations. Wrong: they exist on a permanent basis.

So we could have reacted sooner.

Sadly, we didn't,

because it was an epidemic that didn't concern us directly.

We thought about it and we wasted almost a year.

Whenever a pandemic or an epidemic strikes

any part of the world, we should react promptly.

Globalization doesn't just affect professional football.

It has to involve globalization of healthcare,

with a globalized response to health threats against the world's population.

This is something we're going to learn to do,

another lesson from this Ebola epidemic

-- I hope its ravages will not be such as to make us regret

how slowly we reacted -- is that we are learning

to be proactive and to stem outbreaks with the greatest urgency.

We need to reflect on the period during which

we simply waited for news,

standing idly by -- initially, we simply did nothing.

Non-governmental organizations were the only ones ready,

ready to react, ready to move immediately.

In crises like this, particularly public health crises

like Ebola, Doctors Without Borders reacted very fast.

Doctors Without Borders, Doctors of the World and many other English and American NGOs are always very responsive.

Why? Because these are private organizations.

Urgent situations are their calling cards.

Of course, there are other organizations that do long-term work,

training and education in particular.

But the urgent response organizations are all private.

What we need is a kind of worldwide emergency response team,

with countries contributing on a rotating basis.

This was brought up when Haiti

suffered a major natural disaster.

Natural disasters are easier to deal with

than war-related disasters.

This Ebola epidemic should have

triggered a similar reaction from us.

In Haiti, various countries took turns:

rotation of responsibilities within Europe,

and between Canada, the U.S., etc.

Everyone ended up helping in Haiti.

I would like to see the creation of a permanent organization, ready at all times

to act as first responder -- this would then be followed by a coordinated response from the international community.

If Europe were strong enough,

all 28 countries could take turns managing this first response,

as I've been advocating for many years.

It wouldn't be expensive and it wouldn't require that much manpower.

Supplies would be prepared well ahead of time. That's what missing today.